4 / 2 2 / 2 0 2 0 Activity Basics 1 Week 4 of 4 CALGARY FOOTHILLS 1 Agenda • Homework review • Ergonomics at home and at work • Pacing • Take Home Points CALGARY FOOTHILLS 2
4 / 2 2 / 2 0 2 0 Group Discussion: Homework Review • Self-Monitoring 2 – Neutral spine and posture – Monitoring body mechanics - challenges and successes? • Activity Analysis exercise CALGARY FOOTHILLS 3 Ergonomics CALGARY FOOTHILLS 4
4 / 2 2 / 2 0 2 0 Neutral Spine and Body Mechanics Review 3 Minimize twisting Minimize reaching Maximize strength Conserve energy Goal: Reduce likelihood for excess strain or repetitive stress CALGARY FOOTHILLS 5 Basic Ergonomics • Ergonomics is the fit between the person and their physical environment when completing a task • Awareness of our environment, or 'workspace' for any given activity • Optimal ergonomics promote safe and efficient body mechanics CALGARY FOOTHILLS 6
4 / 2 2 / 2 0 2 0 Task Setup • Using hands directly in front of, and close to body 4 • Light weight activities requiring precision are best done between elbow and under arm level • Light to medium weight activities are best done at approximately elbow level • Heavy activities are best performed between elbow and hip level CALGARY FOOTHILLS 7 Group Discussion: • How are you sitting right now? • What is your workstation set up right now? • Are you feeling any excess muscle strain or tension right now? CALGARY FOOTHILLS 8
4 / 2 2 / 2 0 2 0 Workstation Ergonomics • When working at a desk or counter – Relax your shoulders 5 – Keep your upper arms close to your torso, and elbows bent to approximately 90 degrees – Position your wrist in a straight line with your forearm and fingers – Objects that you reach for frequently need to be closest to your body – Adjust your chair height and use a foot stool if necessary to have your knees level with your hips CALGARY FOOTHILLS 9 Workstation Ergonomics Continued • Remember head posture – Position computer monitors or car mirrors so the chin can remain tucked and head neutral – Consider what part of your glasses you look out of, and pay attention to whether you are lifting your chin (e.g. you may need to lower a monitor if wearing bifocals) – Consider the distance required for visual acuity, and notice if you are poking your chin forward to see CALGARY FOOTHILLS 10
4 / 2 2 / 2 0 2 0 Sitting Position • Sit in a chair with your: - Knees approximately level with your hips - Feet flat on floor or 6 stool, directly under your knees - Weight on bum cheeks (sit bones) - Spine ‘tall’ - Chin tucked • Use a lumbar support to maintain the natural curve in your low back CALGARY FOOTHILLS 11 CALGARY FOOTHILLS 12
4 / 2 2 / 2 0 2 0 Lying Position • Lying down – Thinner pillow under the head for back lying, thicker for side lying 7 – Ears over shoulders over hips – Pillow lengthwise from knees to heels for back lying or between lower legs for side lying – Do not bend hips or elbows more than 90 degrees – Pillow in front of torso to support upper arm in side lying – Hands below shoulder level CALGARY FOOTHILLS 13 Pacing CALGARY FOOTHILLS 14
4 / 2 2 / 2 0 2 0 The Tortoise & The Hare 8 CALGARY FOOTHILLS 15 The Pacing Approach “Active self-management strategy whereby individuals learn to balance time spent on activity and rest for the purpose of achieving increased function and participation in meaningful activities” (Jamieson-Lega, Berry & Brown, 2013, p.207) CALGARY FOOTHILLS 16
4 / 2 2 / 2 0 2 0 Rest and Recovery What is the purpose/intention? 9 Passive, unstructured OR Active, winding down of nervous system following activity CALGARY FOOTHILLS 17 How to Pace? We've already discussed: – Changing position (Posture, Positioning, Body Mechanics) – Modifying the activity (Activity Analysis, Body Mechanics, Ergonomics) We will now add: – Incorporating self-care or leisure activities – Alternating between activities – Planning brief rest periods – Mindset CALGARY FOOTHILLS 18
4 / 2 2 / 2 0 2 0 4 P’s of Pacing 1 0 Positioning Prioritizing Planning Perspective CALGARY FOOTHILLS 19 Positioning (How are you going to do it?) • Pay attention to having neutral spinal posture, good body mechanics and ergonomics during activities • Alternate activities so that you are using different body parts • Use assistive devices to decrease strain on your joints and muscles (e.g., long handled devices, foot on stool in standing position, grab bars, walking poles) CALGARY FOOTHILLS 20
4 / 2 2 / 2 0 2 0 Prioritizing (What do you need to do?) • Prioritizing activities 1 1 • Things you have to do, are expected to do and want to do • Putting them in order of importance • Identifying any you can share or give away • Recognize that thoughts and emotions demand energy too CALGARY FOOTHILLS 21 Planning (When are you doing to do it?) • Choosing a period of time you feel comfortable to plan ahead for • Today, a few days, a week • Create a flexible and balanced schedule to budget your energy output CALGARY FOOTHILLS 22
4 / 2 2 / 2 0 2 0 Planning • How to Plan: • Use a calendar/daytime/organizer 1 2 • Schedule the priority activities based on tolerances • Alternate more and less demanding activities • Schedule them so that no one day is more demanding than the next • Include rest and self-care throughout your day CALGARY FOOTHILLS 23 Perspective (Why are you going to do it?) • Remind yourself that by pacing you will get your most important tasks done within your tolerance levels • Pacing is hard work, and it takes time to get it right • Pacing becomes more automatic with time • Having difficult/unwanted thoughts and feelings is normal CALGARY FOOTHILLS 24
4 / 2 2 / 2 0 2 0 What Happens on a Bad Day? • On a bad day, you are still within your normal range of pain (you are not in a flare-up), so do what you have planned 1 3 • Remind yourself that you will take a break if your pain or fatigue increases by 1- 2 points out of 10 or if you feel that continuing will result in a delayed increase in pain or fatigue • Do not abandon the schedule entirely – remember, our bodies need to move – modify, ask for help with, or eliminate the most demanding tasks • Schedule more breaks and coping strategies – use your self-management plan CALGARY FOOTHILLS 25 What Happens during a Flare-Up? • Flare up plan is individualized to you • May need to modify activities or schedule • Regular use of self-management strategies • Helpful to contact your health care provider for individualized support CALGARY FOOTHILLS 26
4 / 2 2 / 2 0 2 0 If I Feel Good, Can I Do More? • Pacing your activities allows your body to adjust to a more consistent energy output, with fewer peaks and valleys in pain 1 4 and energy • On a good day, do not add a challenging activity, enjoy having less pain or more energy and only add low demanding, enjoyable tasks • Then you will be more likely to have another good day tomorrow CALGARY FOOTHILLS 27 Group Discussion: What stands out for you? • Explain Pain • Rest and Activity • Self-monitoring • Increasing Tolerances • Posture • Activity Analysis • Body Mechanics • Exercises: Stretching and Strengthening • Ergonomics • Pacing CALGARY FOOTHILLS 28
4 / 2 2 / 2 0 2 0 Self-Management Plan 1 5 Please add any self-management strategies you have found helpful from class to your self-management toolbox CALGARY FOOTHILLS 29 Next Steps CALGARY FOOTHILLS 30
4 / 2 2 / 2 0 2 0 1 6 CALGARY FOOTHILLS 31
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